The pediatric inflammatory bowel disease INTERMED: A new clinical tool to assess psychosocial needs

• Autor: Cohen, Janice S. ; Lyons, John S. ; Benchimol, Eric I. ; Carman, Nicholas ; Guertin, Camille ; Mack, David R.
• Assuntos: Adolescent ; Adolescents ; Anxiety ; Assessors ; Biopsychosocial screening ; Child ; Children ; Cognitive ability ; Complexity ; Crohn's disease ; Cross-Sectional Studies ; Family relations ; Female ; Health care ; Help seeking behavior ; Humans ; Inflammatory bowel disease ; Inflammatory bowel diseases ; Inflammatory Bowel Diseases - psychology ; Integrated care ; Interdisciplinary aspects ; Internalization ; Internalizing disorders ; Intestine ; Male ; Mass Screening - methods ; Mental depression ; Mental disorders ; Mental health ; Pediatrics ; Predictive validity ; Psychosocial factors ; Reliability ; Severity ; Social behavior ; Social problems ; Ulcerative colitis
• É parte de: Journal of psychosomatic research, 2019-04, Vol.119, p.26-33
• Notas: ObjectType-Article-1
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• Descrição: The adult INTERMED is used to determine case complexity and psychosocial needs. We developed and validated a pediatric version of the INTERMED for children and adolescents with inflammatory bowel disease (IBD) and assessed its utility in predicting healthcare utilization. We performed a cross-sectional study of children (aged 8–17 y) with IBD (n = 148) and their parents, seen in a hospital-based clinic. Subjects completed semi-structured interviews that were scored on the 34 pIBD-INTERMED items. To assess inter-rater reliability, 40 interviews were videotaped and scored by a second assessor. Convergent and predictive validity were assessed by examining the relation of the pIBD-INTERMED to standardized measures of psychological, social, and family functioning, disease activity, and healthcare utilization. Correlational analyses supported the validity of all five pIBD-INTERMED domains with very good inter-rater reliability (median r = 0.87) and internal consistency (α = 0.91) for the total complexity index. Ratings of 2–3 on the pIBD-INTERMED “mental health/cognitive threat” item were associated with greater odds of behavior and social problems (CBCL-Internalizing scale OR = 7.27, 95% CI 2.17–24.36); CBCL-Externalizing scale OR = 24.79, 95% CI 5.00–122.84), depression (Children's Depression Inventory OR = 8.52, 95% CI 1.70–43.02) and anxiety (Multidimensional Anxiety for Children OR = 11.57, 95% CI 3.00–45.37). The pIBD-INTERMED complexity index added significantly to the prediction of healthcare utilization, beyond the contribution of disease severity. The pIBD-INTERMED is a reliable and valid tool for identifying psychosocial risks and needs of children with IBD. It can be used to guide planning of individualized care and enhance interdisciplinary pediatric IBD care. •A pediatric (pIBD) INTERMED with Crohn's disease or ulcerative colitis was developed as a simple, reliable and valid tool•It can proactively and efficiently identify patient's psychological, social, family/caregiver and health system needs•It can be used to enhance decision making in planning the intensity of psychosocial intervention for pediatric IBD care
  
• Editor: England: Elsevier Inc
  
• Idioma: Inglês